Phyllis:  Maybe you could arrange for a speech or occupational therapist who 
has experience in infant feeding inservice your Level II and Level III nursery 
staff on oral-motor and developmental feeding issues in the young infant.  Our 
Level II nurses have done a complete turnaround in their management of 
bottle feedings to embrace paced feedings after being inserviced and trained a 
few years ago by our therapists.  Initially, they were reluctant, like any 
change in practice, but now would not do a bottle feeding any other way.  
Once our therapists have done an evaluation, they write up a feeding and/or 
positioning plan for the baby and leave it prominently at the baby's bedside so 
that caregivers and parents can follow their recommendations when caring for 
the baby.  The plan is modified as needed over time.  It's a win-win situation. 
Parents are happy, staff is happy, and babies are happy with this continuity 
and teamwork.


Pam Hirsch, BSN,RN,IBCLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL   USA

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